Currently, intracerebral hemorrhage (ICH) has the highest mortality rate of all stroke subtypes (Counsell et al 1995; Qureshi et al 2005). Hematoma growth is a principal cause of early neurological deterioration. Prospective and retrospective studies indicate that up to 38% hematoma expansion is noted within three hours of ICH onset and that hematoma volume is an important predictor of 30-day mortality (Brott et al 1997; Qureshi et al 2005). This article will review current standard of care measures for ICH patients and new research directed at early hemostatic therapy and minimally invasive surgery.